The goal of this competitive renewal is to translate laboratory research on wavefront-guided scleral contact lenses into a clinical solution for highly aberrated eyes that restores retinal image quality to normal or better than normal levels. This will be accomplished by identifying and removing barriers that currently complicate clinical translation. Completion of this goal will allow the research team to test the hypotheses that: 1) A mature visual system (having experienced good retinal image quality during the formative years) that is now habitually experiencing poor retinal image quality due to elevated higher order aberrations will, with time, adapt back to normal levels of visual performance (visual acuity, contrast sensitivity as a function of letter size and stereo-acuity); and 2) normal or better than normal retinal image quality provided by wavefront guided corrections improves quality of life in patients with highly aberrated eyes compared to clinically available non-wavefront guided corrections.